Sleep disorder is a manifestation of the normal rhythm disorder of sleep and awakening, including insomnia, excessive sleepiness, sleep breathing disorder and abnormal sleep behavior caused by various reasons, which can be caused by many factors. The two most common sleep disorders are insomnia and obstructive sleep apnea hypopnea syndrome.

① Insomnia

There are three main reasons for insomnia in the elderly:

First, as the elderly grow older, their ability to regulate sleep is weakened, their sleep time is prolonged and their deep sleep time is reduced, so the incidence of insomnia is higher.

Second, the activities of the elderly during the day are reduced, and fatigue leads to increased sleep. The increase in daytime naps will also shorten the sleep-wake cycle at night, so getting up early or night activities like owls are very common among the elderly.

Third, the incidence of chronic diseases in the elderly is high, and some diseases will affect sleep or cause insomnia. Coupled with frequent toilet visits at night, the circadian rhythm disorder of sleep will be more obvious.

② Obstructive sleep apnea hypopnea syndrome

OSAHS is a kind of sleep disorder in which breathing is shallow or stops during sleep, and its incidence is increasing year by year. According to the community survey of the elderly in China, the incidence of OSAHS in the elderly is very high, accounting for 70% of males and 56% of females.

The basic pathophysiological changes of the disease are repeated hypoxemia, hypercapnia and sleep structure disorder at night, which leads to daytime sleepiness, cardiovascular and cerebrovascular complications and even multiple organ damage, seriously affecting the quality of life and longevity of patients.

2. Sleep disorders and cardiovascular diseases

Compared with normal people, people with sleep disorders will have abnormal phenomena such as increased resting heart rate, decreased heart rate variability, accelerated metabolism, and activation of adrenal axis and β brain wave activity. These mechanisms will aggravate the prevalence of cardiovascular diseases.

① Sleep and hypertension

Professor Yang Tianlun pointed out that sleep disorder is one of the important risk factors of hypertension. Relevant research results also prove this view.

Fang and other researchers used the data of American Health Interview Survey (NHISs) from 2007 to 2009 to evaluate the relationship between self-reported sleep time and the prevalence of hypertension by age and gender. Among 765,438+0,455 participants, the prevalence rates of hypertension in adults who slept less than 6h, 7h, 8h, 9h and ≥ 65,438+00h were 32.4%, 25.5%, 22.2%, 23.2% and 25.5% respectively. The results show that the shorter the sleep time, the higher the prevalence of hypertension.

(Relationship between Hypertension Incidence and Sleep Time)

According to the meta-analysis of the relationship between sleep time and hypertension in China, too short sleep time is related to the increased risk of hypertension, and too long sleep time is also related to the increased risk of hypertension.

② Sleep and coronary heart disease

Coronary heart disease is one of the diseases that seriously endanger human health. In China, the number of people who die of coronary heart disease exceeds 654.38+0 million every year, and the sudden death rate of patients with coronary heart disease in sleep reaches 30%.

A study in India shows that short sleep time and poor sleep quality are independent risk factors for coronary heart disease. The total sleep time was less than 6 hours, and the OR value of coronary heart disease was 3.8 1. The OR value of coronary heart disease in patients with poor sleep quality (Pittsburgh Sleep Quality Index > 5) was 16.62.

Or value, that is, relative risk value.

OR value = 1, indicating that this factor has no effect on the occurrence of diseases;

Or the value > 1, indicating that this factor is a risk factor;

Or the value < 1 indicates that this factor is a protective factor.

Another study on the relationship between sleep time, insomnia and the risk of coronary heart disease in postmenopausal women shows that short sleep time (≤5h) and long sleep time (≥ 10h) will increase the incidence of coronary heart disease, and their risk ratios are 1.25 and 1.43 respectively. After adjusting for age and race, the risk ratio of women with poor sleep quality is 1.38.

All the above studies show that sleep time and sleep quality are important risk factors for coronary heart disease.

③ Sleep and heart failure

Professor Yang Tianlun emphasized that heart failure is a persistent factor that leads to frequent hospitalization and increases mortality. As early as 20 13, there were more than 4.5 million patients with heart failure in China, and the incidence of heart failure will increase with age. In addition, the incidence of sleep disorders and heart failure are interrelated and influenced each other.

First of all, sleep disorders will increase the incidence of heart failure.

A study published in the European Heart Journal found that people with insomnia have a threefold increase in the risk of heart failure. The Norwegian University of Science and Technology conducted a 1 1 year follow-up survey on nearly 54,300 volunteers aged 20-89. The investigation mainly involves whether the subjects have three major insomnia symptoms: difficulty in falling asleep; Lack of sleep; I still feel sleepy after getting up.

During the study, * * * found 14 12 patients with heart failure. Comparative studies have found that people with three insomnia symptoms have a significantly higher risk of heart failure than those with only one or two insomnia symptoms. People with three symptoms of insomnia have an increased risk of heart failure of 45.3%.

In addition, repeated apnea and hypoventilation at night will lead to hypoxemia, aggravate the hypoxia of the heart and tissues, destroy the balance between supply and demand of myocardial oxygen, and aggravate myocardial damage and heart failure.

Secondly, patients with acute heart failure and many patients with chronic heart failure are often accompanied by different degrees of sleep disorders.

Erickson et al. investigated the patients with heart failure whose ejection fraction was less than or equal to 40% for 6 months, and found that 47 of 48 patients had sleep disorders, and13 patients had used sleep drugs. The most common problem is that they can't lie on their backs, followed by lack of sleep, difficulty falling asleep and getting up too early in the morning.

In addition, Matura and other researchers selected 19 1 patients with pulmonary hypertension for social statistics and clinical data research, and the results showed that 66% patients had sleep disorders. And the degree of sleep disorder is directly proportional to the clinical symptoms of pulmonary hypertension, which will lead to right heart failure and premature death. Therefore, improving sleep disorders will improve the quality of life of patients and reduce mortality.

④ Sleep and arrhythmia

Normal heart rhythm is the result of the balance between sympathetic nerve and parasympathetic nerve. Sleep disorder will overactivate sympathetic nerve, which will lead to arrhythmia such as premature beat, ventricular tachycardia, ventricular fibrillation and atrial fibrillation. Although the risk of ventricular premature beats is low, recent research shows that the probability of sudden death or cardiovascular events is 2-3 times higher than that of normal people.

In a word, cardiovascular disease and sleep disorder are mutually causal, and * * * disease exists, so we should intervene and treat it at the same time.

3. Solutions to sleep disorders

As children, we must pay attention to parents' sleep problems and help them improve their sleep quality. Improving sleep can obviously improve the quality of life of elderly patients and reduce the probability of cardiovascular disease.

There are two ways to solve sleep disorders:

① Non-drug therapy

Eliminate all kinds of factors that cause insomnia. Such as eliminating psychological tension (the elderly can reduce mental and physical tension through relaxation training such as meditation, qigong and playing Tai Ji Chuan), changing the sleeping environment, avoiding taking food or drugs that affect sleep before going to bed, and keeping the law of sleep awakening (that is, concentrating on sleep and not thinking about other things) and so on.

② drug therapy

Professor Yang Tianlun said that Wen Fei (Zozopiclone) is the first choice for insomnia. It is the most widely used non-benzodiazepine drug for insomnia in China. It is also the first sedative and hypnotic drug approved by FDA in the United States that can be used for a long time.

Of course, not everyone is suitable for the same drug. Specifically, you need a doctor to analyze the condition and prescribe medicine. Never use medicine yourself.